'Scotland has much to be proud of in the way that the pandemic has been managed. I have no doubt that the death toll would have been greater without the unwavering support and close working relationship between the government and the clinical community.' Dr Dr Stephen Cole, President of the Scottish Intensive Care Society Contributor reminders and comments talkingupreminders@gmail.com

Jackson Carlaw attacks First Minister for deaths in another HC-One private care home which failed inspection in 2019 and 2020

Today, Jackson Carlaw, using a Channel 4 report as evidence, attacked the First Minister for the lack of testing of staff in Highgate Care Home, Uddingston, and by association the deaths there.

On August 16th 2019, the Care Inspectorate rated the HC-One Highgate as follows:

Among the many problems, one was life-threatening:

In August 2019: Requirement 2

The provider must ensure healthcare professionals are involved in assessing and reviewing residents support needs if appropriate.

Timescale: by 31 January 2019

This requirement was [also] made on 11 September 2018.Action taken on previous requirement:

We looked at residents who experienced falls. We found that when health professionals had been contacted for advice about a resident’s falls their instructions had not been recorded in their care plan. This meant theprofessionals instructions had not been followed such as carrying out a multifactorial risk assessment. The resident continued to fall yet there was no further contact with the health professional to discuss any further actions the home could take to try to prevent further falls.

We were also advised that a resident with falls would not be referred to the falls team as they were known to fall. It is not acceptable to label a resident as someone who just falls all the time. This must be monitored better to ensure any changes to the person’s health and wellbeing are responded to.

Not met

On 9th January unannounced: Requirement 2

This requirement was made on 16 August 2019. Action taken on previous requirement:

We looked at daily health charts and found this remained an area that must improve. -oral charts still had gaps in recordings which meant there was no evidence oral care had been carried out or not. There was a resident with several refusals of oral care recorded yet no steps had been taken such as contact with the dentist until after the inspector pointed this out-on personal hygiene charts there was only one space to record oral care yet we would expect residents to be offered oral care twice daily, in the morning and bedtime-personal hygiene charts had few recordings of nail care being carried out-there were long gaps of sometimes several hours in re-positioning charts. This meant there was no evidence people were moved in the identified timescales that would protect their skin.

This from the Daily Mail which,on this occasion, is not making up stuff.

“The failure rate at HC-ONE, which has 230 homes, was 55 per cent.”

The homes examined are in England. It puts into context the standards of care at many of these homes,i ncluding Scottish homes.

The Mail article was published in 2017 so things may have changed for better or worse. A large number of homes were examined.

“Watchdogs have reported on 5,300 care homes this year and 2,000 were found inadequate or in need of improvement.”

Here is a bit more from the Mail article.

“Of 5,361 reports published this year, 38 per cent received the worst two ratings. Just 86 homes were outstanding. Another 262 were rated inadequate – leaving 9,000 residents with no guarantee of being protected from harm.

The Mail’s findings suggest the crisis in care homes is far more severe than previously thought. Last month the CQC published a major report, which suggested that out of 14,900 care homes 22.5 per cent were failing. However, the figures related to reports since October 2014 – rather than being broken down by year.

The Mail’s findings suggest particular concerns with major private providers. Four Seasons Health Care, which houses 20,000 mostly elderly residents in 265 homes, promises that residents will be treated with ‘courtesy and dignity’.

But out of 107 reports into its homes published this year, 54 were rated as failing. Bupa Care Services – the second largest private provider with 244 homes – says it has a ‘person-centred approach’. Yet 45 of 90 of its homes reported on this year were found to be inadequate or requiring improvement.”

““What has happened is that care homes have become financialised,” says Nick Hood, analyst at Opus Restructuring & Insolvency, which has advised several care home chains. “Their owners are playing with the debt and expecting returns of 12 or 14 per cent and that is simply unsuitable for businesses with huge social responsibilities.”

Global private equity, sovereign wealth and hedge funds have piled into the sector in the past three decades, lured by the promise of a steady government income and the long-term demographics of Britain’s ageing population.

Three of the biggest chains — HC-One, Four Seasons and Care UK — are in the hands of buyout groups.

Now the sector is in crisis. All three have been up for sale in the past two years and not found buyers. Hurt by a state mandated rise in the minimum wage, and a decline in funding for local governments, which pay for 60 per cent of their residents, their owners are clamouring for more funding.”

HC-One has now published data on Covid-19 cases and related deaths in its care homes. These numbers are cumulative since the start of the UK COVID-19 outbreak. As of 12th May 2020:

4,747 suspected or confirmed cases of COVID-19 to date in HC-One homes

856 deaths with suspected or confirmed COVID-19 to date

(By my calculation: 18.0% of cases resulting in death.)

Candidly, its not absolutely clear from the company’s text whether the above figures are for its homes across the whole UK or just the rUK excluding Scotland.

In the same information release, it provides this separately for its homes in Scotland:

982 suspected or confirmed cases of COVID-19 to date

201 deaths with suspected or confirmed COVID-19 to date

(By my calculation: 20.5% of cases resulting in death.)

HC-One adds: “These numbers encompass confirmed tests and suspected cases in our homes, based on the clinical assessment of a GP, Community Matron or a member of our own clinical team.” It also states: “Please note we will not be providing home-level breakdowns.”

“Nursing Care
In each of our Nursing Care Homes we employ registered nurses to deliver professional nursing care to Residents with complex nursing needs.

Nursing Assistants
In response to the nursing shortage in the United Kingdom, HC-One has developed a team of highly skilled and qualified Nursing Assistants; our Nursing Assistants have all attended rigorous training and professional development so that they can support the nursing teams within our nursing care homes.”

Registered nurses were replaced by nursing assistants, meaning a single nurse in a unit may now be responsible for the care, documentation, liaison, etc ad infinitem for 30 residents where there were two nurses previously. Last time I worked in a nursing home I had NINE residents in my unit. And we wonder why care becomes compromised. These are not Best Marigold Hotel, they are NURSING homes, some residents have more complex needs than others but they all have nursing needs which require complex skills and knowledge to deliver.

'Scotland has much to be proud of in the way that the pandemic has been managed. I have no doubt that the death toll would have been greater without the unwavering support and close working relationship between the government and the clinical community.' Dr Dr Stephen Cole, President of the Scottish Intensive Care Society Contributor reminders and comments talkingupreminders@gmail.com

'Scotland has much to be proud of in the way that the pandemic has been managed. I have no doubt that the death toll would have been greater without the unwavering support and close working relationship between the government and the clinical community.' Dr Dr Stephen Cole, President of the Scottish Intensive Care Society Contributor reminders and comments talkingupreminders@gmail.com

'Scotland has much to be proud of in the way that the pandemic has been managed. I have no doubt that the death toll would have been greater without the unwavering support and close working relationship between the government and the clinical community.' Dr Dr Stephen Cole, President of the Scottish Intensive Care Society Contributor reminders and comments talkingupreminders@gmail.com

'Scotland has much to be proud of in the way that the pandemic has been managed. I have no doubt that the death toll would have been greater without the unwavering support and close working relationship between the government and the clinical community.' Dr Dr Stephen Cole, President of the Scottish Intensive Care Society Contributor reminders and comments talkingupreminders@gmail.com